PREPARATIONS: Tablets: 0.25, 0.5, 1 and 2 mg. Tablets ER (extended release): 0.5, 1, 2 and 3 mg. Tablets (Orally disintegrating): 0.25, 0.5, 1 and 2 mg. Solution: 1 mg/ml
The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily.
The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily. The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily.
DRUG INTERACTIONS: Alprazolam interacts with
- Ketoconazole (Nizoral),
- itraconazole (Sporanox),
- nefazodone (Serzone),
- cimetidine (Tagamet), and
- fluvoxamine (Luvox).
These increase concentrations in the blood of alprazolam and therefore may increase the side effects of alprazolam. Alprazolam interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation.
PREGNANCY AND BREASTFEEDING SAFETY: Benzodiazepines, such as alprazolam, can cause fetal abnormalities and should not be used in pregnancy.
Alprazolam is excreted in breast milk and can affect nursing infants. Therefore, it should not be used by women who are nursing.
STORAGE: Alprazolam should be stored at room temperature, 15 C to 30 C (59 F to 86 F).
DOSING: Alprazolam may be taken with or without food.
DRUG CLASS AND MECHANISM: Alprazolam is an anti-anxiety medication in the benzodiazepine family, the same family that includes diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), flurazepam (Dalmane), and others. Alprazolam and other benzodiazepines act by enhancing the effects of gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter (a chemical that nerve cells use to communicate with each other) that inhibits activity in the brain. It is believed that excessive activity in the brain may cause anxiety or other psychiatric disorders. The FDA approved alprazolam in October 1981.
Medically reviewed by Eni Williams, PharmD
FDA Prescribing Information
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